52252 11.0_1 Elmsford,
Tract No. 3 �?6 -Lot No.R4
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 1 — , .i9 G 7 Permit No.S Z Z5_Z--
Application is hereby made a permit to �'p✓ QQ
a story, Type ld / Use Zone ._F—CL6
/ ( cc ncy. I
to be occupias_S%o[-/L_'� • s 1/rj �/v ' " Pace
ed on y
in accordance with Plans, Specifications and Plot-plan filed herewith.
Fire Sprinkler �—
Estimated Value of Improvements, $A0 •o o.r a
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ w 113
g � ' �/
Undersigned attests that his State of California Contractor's License #13
is in full force and effect and properly authorizes this application.
San Jose City Business License # 4 — /0 8
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California. _
Owner� .T /N✓�✓7'�� t i}tloe TNGgddress //�S—.S 6- .SV -
Address rW r i¢r egaevc
99/5-WOI- 08Z .1%
ys.w
p — 000n}S
uottepunod
NO11OUSN1 d0 G8Oo3a